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HomeMy WebLinkAboutMortgage_Lashbrook°'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year �__ FOR DEDUCTION FROM ASSESSED VALUATION �� � SYale Fortn 43709 (R8l 2O7) � �' ,.,, � Presmbed by Department of Local Govemment Finance INS7RUCT10NS: � A�t� Mark To be filed in person or by mad wifh the CountyAuditor o/ the county where fhe proper(y is bwted. 9 Z ��8 Fdo�g Dates: 1 J Real Property: During the 12 months be%re June 77 W the year the deduc6on is to be eRective. ._., 2) Mobi7e Homes assessed under IC 6-7.7-7: Between January 75 and Maich 2 of the year the deducUon is fo be � See reverse side la additional instructions and quali�icafions. � GIBSONCOIiNrv ���„�r,._ Applicairt(owner�mn uyer-see�sMCff�mrev � DisUiC KeynumberQ/legaldesai= `� o• O d rdue of �eal poperty as of March 1, aa2n1 year Mor�g� arten If ro what is his I trer exact share M interest? If� m record is d'Aierenl ihan Ihal of applican4 indiple 6elow: Name of mortgagee or mmaU seller � Address of rtartgagee a mntracl seller (number and streef. dty, sf Name of assig�e or other awner w hdder of moAga9e Atldress rity, sfafe. and ZIP wtlel Jce. � �� �� �W�c • /I 1 v�+�+ I ConiraU iMe6ledness unpaid as of March 1, If awned wM someane al} aMZ ode) ` ovm property in anY olha � '�' Dra�ti-erN a��-/�G ❑Yes ❑ No 3 . . , . .� ...... — Cardi'O. Deduction approveA in the amount of: '''••-� zo_2� p� C, �� ��G�%, ov � Siqnature af Counry Record 19Ihe appfinnl ihe ❑ Yes � No spouse, �s Ihe property in questim: ❑ Real Prooertv ❑ Modle Hwne (IC G7. Zo uested on prapeM ❑Yes ❑No zo 1/ We certify under the penalty of perjury that ihe above and foregoing infortnation is true and corted and tliat tl�e applicants was / were a resident af Indiana and owner of the afwementioned property on March 7, 20 � e(o s M1dl name) Date (mmth, daY. Y��) . ��.� ,/l. _ o� of Nfarney or M euthoraed pason (number aM sLeet cdy, sfate, aM LP oode) � (monN, tlay, yea�